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CDC Urges Anti-HIV Pill for People at High Risk of Infection

CDC Urges Anti-HIV Pill for People at High Risk of Infection

05/15/14

WEDNESDAY, May 14, 2014 (HealthDay News) -- People deemed to be
at high risk for contracting HIV, the virus that causes AIDS,
should take anti-HIV medicines that seem to cut transmission risk,
the U.S. Centers for Disease Control and Prevention announced
Wednesday.

If used consistently, this approach, called pre-exposure
prophylaxis (PrEP), has been shown to reduce HIV infection rates in
prior studies by as much as 90 percent, the CDC noted.

"HIV infection is preventable, yet every year we see some 50,000 new HIV infections in the United States," CDC director Dr. Tom Frieden said in a news release from the agency. "PrEP, used along with other prevention strategies, has the potential to help at-risk individuals protect themselves and reduce new HIV infections in the United States."

The new guidelines are tied to the 2012 approval by the U.S.
Food and Drug Administration of a combo drug called Truvada for use
as PrEP, along with safe sex practices.

"While a vaccine or cure may one day end the HIV epidemic, PrEP is a powerful tool that has the potential to alter the course of the U.S. HIV epidemic today," Dr. Jonathan Mermin, director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, said in the news release.

The new guidelines say that the use of the PrEP regimen should
be considered by the following groups:

Anyone involved in an ongoing relationship with a person who is
already infected with HIV;

Any gay or bisexual man who has had sex without a condom or who
has been diagnosed with a sexually transmitted infection within the
past six months, and is not in a mutually monogamous relationship
with someone who recently tested HIV-negative;

A heterosexual person who does not always use condoms when
having sex with people who might be at high risk for HIV (injection
drug users or bisexual male partners whose HIV status is unknown)
and is also not involved with an HIV-negative person in a mutually
monogamous relationship;

Anyone who has abused injected, illicit drugs over the past six
months, shared needles or other equipment tied to injected drug
abuse, or been in a drug abuse treatment program.

The CDC is offering PrEP providers with support to help make
sure that people on the regimen adhere to it as closely as possible
-- always an issue, the agency said. Pills need to be taken
regularly or the level of protection from PrEP drops dramatically,
the CDC noted.

One expert in the field said that preventing HIV will always
take more than a pill.

"We applaud the CDC for acknowledging the effectiveness of PrEP to reduce the risk of HIV infection among those individuals at greatest risk of HIV transmission," said Dr. Michael Mullen, professor of medicine and infectious diseases at the Icahn School of Medicine at Mount Sinai, in New York City.

"However, it must be emphasized that PrEP cannot and should not be used alone as prophylaxis against HIV infection -- rather, PrEP must be used in combination with other proven preventive measures, including practicing safe sex, being tested regularly for STDs, and knowing your and your partner's HIV status," he said.

Dr. Dawn Smith is the epidemiologist in CDC's Division of
HIV/AIDS Prevention who led the development of the guidelines. She
stressed that, "individuals will have to decide with their doctor
if PrEP is right for them, but for some, this may offer a
much-needed strategy to help protect themselves from HIV
infection."

But the strategy will require teamwork, she added.

"PrEP is a new approach to HIV prevention that requires continuing collaboration between patients and providers, as effectiveness requires adherence to daily medication and regular medical visits for monitoring, counseling and testing," Smith said.

The new guidelines were published May 14 in the CDC journal
Morbidity and Mortality Weekly Report.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.